NPIMap

Individual provider Active NPI

Nicole Catherine Thies, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1811479736
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1210 W 18TH St Ste 100
Sioux Falls, SD 57104-4650
Phone
(605) 312-8500
Fax
(605) 312-8501
NPI assigned
Sep 6, 2018
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X SD Primary

Addresses

Primary practice location

1210 W 18TH St Ste 100
Sioux Falls, SD 57104-4650

Mailing address

3816 E Huntington St
Sioux Falls, SD 57103-6360
Phone (507) 381-6325

Other names 1

  • Ms. Nicole Catherine Gosson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190117000700 SD Practitioner - Physician Assistant 8325384001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Sanford School of Medicine of University of South Dakota, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

6100 S Louise Ave
Sioux Falls, SD 57108-6029

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1166SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan CurrentSince Dec 1, 2022 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

6100 S Louise Ave
Ste 1500
Sioux Falls, SD 57108
Phone (605) 504-1100

6100 S Louise Ave
Ste 2100
Sioux Falls, SD 57108
Phone (605) 504-1100

6800 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 322-3278

911 E 20th St
Ste 300
Sioux Falls, SD 57105
Phone (605) 322-1300

Interoperability endpoints

  • Direct secure messaging: nicole.thies@avera.sdhealthlink.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1811479736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 E HUNTINGTON ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571036360",
            "telephone_number": "507-381-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044650",
            "telephone_number": "605-312-8500",
            "fax_number": "605-312-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIES",
        "first_name": "NICOLE",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GOSSON",
            "middle_name": "CATHERINE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.